Aim-To assess the validity of negative cervical smear reports in women who subsequently developed cervical cancer; and to determine means of improving the screening process. Methods-One hundred and forty cervical smears, initially reported as negative from 103 women, and taken up to 12 years before diagnosis of cervical cancer, were reviewed. Results-Ninety two smears contained dyskaryotic cells. Analysis showed that these smears formed several well defined patterns. False negative reports were likely to occur if fragments of neoplastic tissue rather than dissociated dyskaryotic cells were present or if the smear contained few dyskaryotic cells. Screening fatigue appeared to be a factor in others. It was also considered important that smears contained cells from the endocervix. These were deficient in 64% of the 47 smears confirmed as negative on review and in 69% of smears containing only a few dyskaryotic cells. Conclusions-Current methods of quality assurance will not remedy these defects in the screening process. It is the responsibility of laboratories to identify sources of poor smears and liaise with smear takers to ensure an improvement in quality. Assessment of the quality of smears received by a laboratory should become an important part of audit. Staff training should place more emphasis on the interpretation of "microbiopsies". The adoption of a quick scanning technique before conventional screening would probably also substantially reduce false negative results. (7 Clin Pathol 1993;46:700-702)
Our results indicate that cytological surveiliance is acceptably safe provided that biopsy is advised if dyskaryosis persists.
IntroductionFormerly a cervical smear that showed mild
Summary.
The effect of vincristine on the platelet count of rats is described. It was found that, depending upon dosage, the drug can cause either a thrombocytosis or marrow hypoplasia with thrombocytopenia in normal rats. Thrombocytosis was found even after prolonged treatment with vincristine when this was given at appropriate dosage.
The thrombocytosis promoting effect of the drug was not enhanced by an increase in the splenic platelet pool or decreased by splenectomy. However, it was abolished when prior treatment was given to suppress marrow thrombopoiesis.
Thrombocytosis was produced in rats by repeated doses of vincristine over a period of three weeks. Using 75Se Selenomethionine to assess platelet production, evidence was obtained that vincristine induces an increase in the platelet count by causing an increase in thrombopoiesis.
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